# Healthcare experiences and barriers as predictors of suicidal thoughts and behaviors among transgender adults: an elastic net regression analysis

## TL;DR

This study explores how healthcare experiences and barriers affect suicide risk among transgender adults in the U.S.

## Contribution

The study uses elastic net regression to identify key predictors of suicidal thoughts and behaviors in transgender populations.

## Key findings

- Worries about negative evaluation from healthcare providers strongly predict suicidal thoughts and behaviors.
- Inability to access healthcare due to cost is linked to increased suicide plans.
- Having health insurance is associated with reduced odds of suicidal ideation with intent.

## Abstract

Suicide is a critical public health concern, particularly among transgender and gender diverse (TGD) individuals The current study aims to identify structural and interpersonal barriers as well as protective factors that impact suicide risk among transgender and gender diverse adults.

The currently analyses utilize the TransPop dataset, the first national probability sample of 274 adult transgender adults in the United States. Elastic net regression was used to examine the relationships between the set of 17 healthcare predictor variables and STB outcome variables.

Worries about negative evaluation from healthcare providers emerged as highly important variables across STB outcomes. Inability to access healthcare due to the cost of seeing a doctor was associated with increased suicide plans. Having insurance was associated with decreased odds of suicidal ideation with intent.

There is a need for increased supportiveness and acceptance from healthcare providers as well as a need to ensure that TGD individuals have access to high-quality mental and physical healthcare.

The online version contains supplementary material available at 10.1007/s00127-025-02977-2.